Ischemic lesions and superficial siderosis in CAA: Partners in crime or innocent bystanders?

Cerebral amyloid angiopathy (CAA), first described in 1927 as a congophilic angiopathy associated with amyloid plaque in brains of patients with Alzheimer dementia,1 has an association with large and small intracranial hemorrhages (ICH). The differential diagnosis of ICH therefore includes CAA, especially in older patients or those without hypertension. The widely used Boston Criteria for diagnosis of CAA in vivo rely on the hemorrhagic characteristics of the disease.2 The pathophysiology of ICH in CAA remains uncertain. Thus, its prognosis, risk stratification, and clinical management present a challenge. Additional imaging features of CAA have contributed potential new perspectives on pathophysiology. The report of ischemic lesions in CAA may represent a novel concept for most clinicians accustomed to thinking about CAA as a hemorrhagic disease. The observation that Alzheimer dementia brains with severe amyloid angiopathy had more prevalent infarcts3–5 prompted subsequent investigations suggesting that amyloid deposition in small and medium-sized cortical vessels may play an active role in ischemia through pathologic thickening of the vessel wall, producing reduction or obliteration of the vessel lumen.6,7 Cortical superficial siderosis (cSS), easy to detect with modern MRI, is a striking and common feature of CAA. How these additional imaging features fit into a larger model of CAA remains unclear. Are they an epiphenomenon or can they teach us about the disease? In ...
Source: Neurology - Category: Neurology Authors: Tags: EDITORIALS Source Type: research

Related Links:

Lifestyle habits matter when it comes to brain health, and the rewards of increased mental stimulation can be seen in a very short space of timeSharon, a 46-year-old single mother of three teenagers, came to see me about her increasing forgetfulness. Working full-time and managing her household was becoming overwhelming for her, and she was misplacing lunchboxes, missing appointments and having trouble focusing her attention. She was worried because her grandmother got Alzheimer ’s disease at the age of 79, and Sharon felt she might be getting it too – just a lot younger. I said it was highly unlikely that Shar...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Health & wellbeing Memory Life and style Mental health Psychology Source Type: news
This article, unfortunately paywalled, is interesting to note as a mark of the now increasingly energetic expansion of commercial efforts in longevity science. David Sinclair has been building a private equity company to work in many areas relevant to this present generation of commercial longevity science; while I'm not sold on his primary research interests as the basis for meaningful treatments for aging, he is diversifying considerably here, including into senolytics, the clearance of senescent cells demonstrated to produce rejuvenation in animal studies. This sort of approach to business mixes aspects of investing and...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Abstract BACKGROUND: Cerebrovascular pathologies and hypertension could play a vital role in Alzheimer disease (AD) progression. However, whether cerebrovascular pathologies and hypertension accelerate AD progression through an independent or interaction effect is unknown. OBJECTIVE: To investigate the effect of the interactions of cerebrovascular pathologies and hypertension on AD progression. METHOD: A retrospective longitudinal study was conducted to compare AD courses in patients with different severities of cerebral white matter changes (WMCs) in relation to hypertension. Annual comprehensive psycho...
Source: Current Alzheimer Research - Category: Neurology Authors: Tags: Curr Alzheimer Res Source Type: research
Low bone mineral density (BMD) is correlated with Alzheimer's disease and its severity, but the association remains unclear in adults (≥50 years) without a history of stroke or dementia. We assessed BMD and cognitive function using the Mini-Mental Status Examination (MMSE) in 650 stroke- and dementia-free subjects (≥50 years) who were recruited for an early health check-up program between January 2009 and December 2010. The mean age was 62.9 ± 8.0 years and mean MMSE score was 27.6 ± 3.6. A total of 361 subjects had reduced BMD: 197 (30.3%) had osteopenia and 154 (23.6%) had osteoporosis, base...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Abstract Compounds targeted for the treatment of Alzheimer's Disease (AD) have consistently failed in clinical trials despite evidence for target engagement and pharmacodynamic activity. This questions the relevance of compounds acting at current AD drug targets - the majority of which reflect the seminal amyloid and, to a far lesser extent, tau hypotheses - and limitations in understanding AD causality as distinct from general dementia. The preeminence of amyloid and tau led to many alternative approaches to AD therapeutics being ignored or underfunded to the extent that their causal versus contributory role in A...
Source: Biochemical Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Biochem Pharmacol Source Type: research
Authors: Cheng CM, Chang WH, Chiu YC, Sun Y, Lee HJ, Tang LY, Wang PN, Chiu MJ, Yang CH, Tsai SJ, Tsai CF Abstract BACKGROUND: Polypharmacy, defined as the concomitant use of 5 or more medications, has a documented negative association with cognitive impairment such as delirium and is associated, potentially, with a higher risk of dementia. However, whether polypharmacy contributes to increased risk of mild cognitive impairment (MCI) or decreased cognitive capacity requires further investigation. This nationwide population survey investigated the association among polypharmacy, MCI, and dementia. METHODS: Throu...
Source: Journal of Clinical Psychiatry - Category: Psychiatry Tags: J Clin Psychiatry Source Type: research
Recent evidence highlights the effects of obesity, diabetes and hypertension in the development of Alzheimer's disease. Involuntary body weight changes in patients with different stages of dementia can be related to clinical factors of the patient per se or support from their caregivers. Understanding the interactions among factors is important to establish a monitoring paradigm to guide treatment strategies.
Source: Clinical Nutrition - Category: Nutrition Authors: Tags: Original article Source Type: research
A number of risk factors are known for dementia; these include hypertension, a sedentary lifestyle, obesity, and smoking. A new study may add another.
Source: Health News from Medical News Today - Category: Consumer Health News Tags: Alzheimer's / Dementia Source Type: news
In this study, we found that TXNIP deficiency induces accelerated senescent phenotypes of mouse embryonic fibroblast (MEF) cells under high glucose condition and that the induction of cellular ROS or AKT activation is critical for cellular senescence. Our results also revealed that TXNIP inhibits AKT activity by a direct interaction, which is upregulated by high glucose and H2O2 treatment. In addition, TXNIP knockout mice exhibited an increase in glucose uptake and aging-associated phenotypes including a decrease in energy metabolism and induction of cellular senescence and aging-associated gene expression. We propose that...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Encouraging older black adults with mild cognitive impairment (MCI) to set goals and develop plans to increase cognitive, physical, and/or social activities may help to slow cognitive decline, according to astudy published Monday inJAMA Neurology.MCI is known to increase the risk of progressive cognitive decline. While some observational studies have suggested that engaging in cognitive, physical, and/or social activity may prevent cognitive decline, “these studies have included few black individuals who may differ from white individuals in risk profile (e.g., cognitive reserve, hypertension, diabetes), mechanisms of...
Source: Psychiatr News - Category: Psychiatry Tags: Barry Rovner behavioral activation blacks health equity JAMA Neurology MCI mild cognitive impairment supportive therapy Source Type: research
More News: Alzheimer's | Brain | Dementia | Hypertension | Neurology | Teaching | Universities & Medical Training